Kitty vs Methimazole. Kitty losing.
March 29, 2018 3:46 PM Subscribe
Our 15 year old cat, Sam was diagnosed with hyperthyroidism this past summer and was prescribed methimazole. He has gone from 11lbs to 6lbs, is nauseous and vomits, and barely eats. We've tried everything we, and the internet, can think of. What else can we do for him?
Sam (pictured here when he was healthier and now, asking me for food) is constantly hungry. There's nothing we can give him that he wants to eat. Tuna, Salmon, Fancy Feast, dried food, wet food, etc. He'll eat food that's fresh from a can, but the same food he'll reject 15 minutes later, and he's in the kitchen begging for more. We give him something else, or more food, and he'll reject that as well, despite giving us signs that he's hungry. We've put a smorgasbord of food down, opened up multiple cans of food, and we're lucky if we can get him to eat something once a day.
We've taken Sam to the vet and had his labs done. His bloodwork is fine, but he's experiencing nausea and vomiting due to the methimazole. Our vet has no options for us. We're not in the U.S., and we don't have a lot of options in the country we're currently in. Radioiodine treatment for cats is not done here nor is surgery an option.
In summary, here's what we've done:
- Reviewed and asked questions on the Yahoo groups for cats with HyperT to no avail
- given him multiple options of food, canned and dried
- add tuna juice to food
- mix in tuna or salmon into his regular food
- straight up give him tuna or salmon
- added cat-friendly gravies and broths to food
- added fish food to the top of his food
- raised his food bowl
- kitten food
- Cerenia (an antimetic) everyday for vomiting (this is working)
- Pepcid for stomach acid (started yesterday)
Here's what we cannot do for Reasons:
- order specialty foods online
- find specialty foods in nearby towns
- cook food especially for him
- travel out of the country for vet visits or treatments
This isn't sustainable for Sam or for us, and we don't know what else to do. We're out of ideas, he's slowly wasting away in front of us, he's unhappy, and we're heartbroken that he's going through this.
Turning to the green to see if anyone has ideas that we haven't tried.
Sam (pictured here when he was healthier and now, asking me for food) is constantly hungry. There's nothing we can give him that he wants to eat. Tuna, Salmon, Fancy Feast, dried food, wet food, etc. He'll eat food that's fresh from a can, but the same food he'll reject 15 minutes later, and he's in the kitchen begging for more. We give him something else, or more food, and he'll reject that as well, despite giving us signs that he's hungry. We've put a smorgasbord of food down, opened up multiple cans of food, and we're lucky if we can get him to eat something once a day.
We've taken Sam to the vet and had his labs done. His bloodwork is fine, but he's experiencing nausea and vomiting due to the methimazole. Our vet has no options for us. We're not in the U.S., and we don't have a lot of options in the country we're currently in. Radioiodine treatment for cats is not done here nor is surgery an option.
In summary, here's what we've done:
- Reviewed and asked questions on the Yahoo groups for cats with HyperT to no avail
- given him multiple options of food, canned and dried
- add tuna juice to food
- mix in tuna or salmon into his regular food
- straight up give him tuna or salmon
- added cat-friendly gravies and broths to food
- added fish food to the top of his food
- raised his food bowl
- kitten food
- Cerenia (an antimetic) everyday for vomiting (this is working)
- Pepcid for stomach acid (started yesterday)
Here's what we cannot do for Reasons:
- order specialty foods online
- find specialty foods in nearby towns
- cook food especially for him
- travel out of the country for vet visits or treatments
This isn't sustainable for Sam or for us, and we don't know what else to do. We're out of ideas, he's slowly wasting away in front of us, he's unhappy, and we're heartbroken that he's going through this.
Turning to the green to see if anyone has ideas that we haven't tried.
Are his teeth okay?
posted by yes I said yes I will Yes at 3:54 PM on March 29, 2018
posted by yes I said yes I will Yes at 3:54 PM on March 29, 2018
When my kitty wasn’t eating due to severely stuffed up sinuses they put a feeding tube into her throat as an emergency “get food into this stomach now” measure. But it’s a big time commitment and doesn’t solve the underlying issue. With our kitty we just had to wait until her sinus infection cleared. Ultimately if the anti-emetic and meds to treat the thyroid don’t work then the sad truth is that kitty is sick and it might take his life. There are ways to ensure that he doesn’t have to starve to death. I’m very sorry you’re going through this, it’s a very unhappy and difficult thing.
posted by bleep at 3:57 PM on March 29, 2018
posted by bleep at 3:57 PM on March 29, 2018
Maybe try some propanolol or some other beta-blocker, even if it's just palliative? Can he get propylthiouracil?
posted by gemutlichkeit at 3:58 PM on March 29, 2018
posted by gemutlichkeit at 3:58 PM on March 29, 2018
Response by poster: The vet has checked his teeth and mouth for sores, and he's all good there. Vet believes it's a reaction to the medication.
posted by vivzan at 4:00 PM on March 29, 2018
posted by vivzan at 4:00 PM on March 29, 2018
Plain chicken or beef baby food (try to find some without too much salt) always gets my guy going.
Vanilla ice cream (maybe Haagen Daaz for extra fat and calories), too.
posted by pseudostrabismus at 4:02 PM on March 29, 2018 [2 favorites]
Vanilla ice cream (maybe Haagen Daaz for extra fat and calories), too.
posted by pseudostrabismus at 4:02 PM on March 29, 2018 [2 favorites]
If it’s a reaction to the medication maybe some other stuff to treat the symptoms of hyperthyroid might give him a better quality of life. My kitty is on amlodipine to treat high blood pressure caused by hyperthyroid.
posted by bleep at 4:02 PM on March 29, 2018 [1 favorite]
posted by bleep at 4:02 PM on March 29, 2018 [1 favorite]
Have you tried giving him cat treats? My cat likes them much better than regular dry food. I also hand feed my cat ( from a plastic spoon) baby chicken or turkey food. I also cook him plain chicken breast. You can also try giving broths on their own. It's not as good as if he eats it with solid food, but maybe he'll lick up the broth and at least get more calories. Also isn't there an anti nausea medication he can take in addition to the hyperthyroid medication?
posted by Blitz at 4:20 PM on March 29, 2018 [1 favorite]
posted by Blitz at 4:20 PM on March 29, 2018 [1 favorite]
A couple of things that helped for a while with our hyperthyroid guy:
- If you're currently doing the methimazole gel, and you think you can get your guy to take pills without too much misery, maybe try a switch to the pill form. My vet said that some cats seem to respond better to it taken orally. (Conversely, I suppose if you're doing it the other way, it might be worth seeing if a switch would help with the side effects?)
- Likewise, this one really depends on how easygoing he is about medical stuff, but if you think you might be able to give him subq fluids, it would be worth discussing with your vet. Per our vet, sometimes the thyroid symptoms can mask some other issues (kidney, if I recall?) that can also be responsible for some of the symptoms. Subq fluids (three times a week at first, then down to two once his weight stabilized) helped make our guy comfortable for a few extra months. I wouldn't do this with every cat, but our guy was extremely chill and didn't seem to mind at all after the first couple of times when we were still getting the routine down, and I don't regret going that route for him to give him a few more comfortable and happy months.
- Yes to smelly baby food, a meat flavor, no onion or garlic. That's my most heavy-duty tool for cats who won't eat; sometimes it's smelly enough to jump-start an appetite. Halo Liv-a-Litle cat treats are also effective; the fish are the smelliest kind but chicken is the most beloved flavor in my house.
- There's nutritional gel stuff that in theory you can smear on a cat's paw and they lick it off and get calories that way. I have never found my cats particularly interested in eating it, vs. just wiping it off on the floor in horror, but ymmv.
posted by Stacey at 4:25 PM on March 29, 2018 [1 favorite]
- If you're currently doing the methimazole gel, and you think you can get your guy to take pills without too much misery, maybe try a switch to the pill form. My vet said that some cats seem to respond better to it taken orally. (Conversely, I suppose if you're doing it the other way, it might be worth seeing if a switch would help with the side effects?)
- Likewise, this one really depends on how easygoing he is about medical stuff, but if you think you might be able to give him subq fluids, it would be worth discussing with your vet. Per our vet, sometimes the thyroid symptoms can mask some other issues (kidney, if I recall?) that can also be responsible for some of the symptoms. Subq fluids (three times a week at first, then down to two once his weight stabilized) helped make our guy comfortable for a few extra months. I wouldn't do this with every cat, but our guy was extremely chill and didn't seem to mind at all after the first couple of times when we were still getting the routine down, and I don't regret going that route for him to give him a few more comfortable and happy months.
- Yes to smelly baby food, a meat flavor, no onion or garlic. That's my most heavy-duty tool for cats who won't eat; sometimes it's smelly enough to jump-start an appetite. Halo Liv-a-Litle cat treats are also effective; the fish are the smelliest kind but chicken is the most beloved flavor in my house.
- There's nutritional gel stuff that in theory you can smear on a cat's paw and they lick it off and get calories that way. I have never found my cats particularly interested in eating it, vs. just wiping it off on the floor in horror, but ymmv.
posted by Stacey at 4:25 PM on March 29, 2018 [1 favorite]
I don’t want to scare you, but my kitty’s hyperthyroid was masking lung cancer. I’d ask for a chest X-ray.
posted by sevensnowflakes at 4:28 PM on March 29, 2018
posted by sevensnowflakes at 4:28 PM on March 29, 2018
My cat thrived on the Hill's y/d cat food for hyperthyroidism, and after just three weeks on the food needed no more medication, with her blood tests all showing as normal. It gave her another two years of an already long life.
posted by essexjan at 4:32 PM on March 29, 2018
posted by essexjan at 4:32 PM on March 29, 2018
^ exact same experience with y/d until it came into conflict with a different health issue.
posted by ftm at 4:41 PM on March 29, 2018
posted by ftm at 4:41 PM on March 29, 2018
Were the symptoms of his untreated hyperthyroidism worse than what he's going through now? 15 is pretty old for a cat, and I wonder if these attempts to treat his hyperthyroidism may be affecting his quality of life worse than just coping with the hyperthyroidism and letting him eat like a normal kitty again. I say all this with no veterinary experience at all, but when a cat is 15 I think maybe you should err on the side of making them happy and healthy now instead of trying to keep them healthier in the long run. To be blunt, you don't know if there will even be a long run.
Barring taking him off his hyperthyroidism meds or adjusting the dose, I think you might have to do some custom cooking for him. I wonder if he'd eat some chicken or beef broth. Try some cheap luncheon meat, if you haven't already. Or try some vanilla ice cream. Our guy would greedily eat ice cream even when he wouldn't eat anything else.
This does sound stressful for all concerned, and I hope your cat is feeling much better very soon!
posted by Ursula Hitler at 4:56 PM on March 29, 2018 [5 favorites]
Barring taking him off his hyperthyroidism meds or adjusting the dose, I think you might have to do some custom cooking for him. I wonder if he'd eat some chicken or beef broth. Try some cheap luncheon meat, if you haven't already. Or try some vanilla ice cream. Our guy would greedily eat ice cream even when he wouldn't eat anything else.
This does sound stressful for all concerned, and I hope your cat is feeling much better very soon!
posted by Ursula Hitler at 4:56 PM on March 29, 2018 [5 favorites]
When one of my kitties stopped eating due to some health reasons, the vet was very concerned because apparently the longer they don't eat and the more weight they lose, the less appetite they have, and it can all snowball very quickly. I wound up having to syringe feed him for about a week, and then eventually his appetite did come back and he had a couple more good years after that. If we had not force-fed him I don't think he'd have lasted the month.
I'm wondering if you might need to consider doing that so he doesn't go too far downhill while you are figuring out a longer-term solution.
posted by Serene Empress Dork at 5:03 PM on March 29, 2018 [1 favorite]
I'm wondering if you might need to consider doing that so he doesn't go too far downhill while you are figuring out a longer-term solution.
posted by Serene Empress Dork at 5:03 PM on March 29, 2018 [1 favorite]
Best answer: While dietary therapy (y/d) would be great, OP stated they can't feed prescription diets.
I read that you recently had your cat's blood work tested but it is not unusual for older cats to have multiple issues (hyperthyroidism/renal insufficiency and GI disease). Sometimes hyperthyroidism can make renal disease harder to detect, for example.
Is transdermal methimazole an option? It has fewer GI side effects than oral formulations.
Has her dose of methimazole been adjusted in response to her total T4 levels and weight loss?
Another medication often given to cats for inappetence is mirtazapine. It is a generic human drug that is typically given to cats every 3 days. The cerenia and pepcid should also help with nausea.
>Maybe try some propanolol or some other beta-blocker, even if it's just palliative? Can he get propylthiouracil?
Or maybe not, since we use a more selective beta blocker for cats with hyperthyroidism only if we are seeing tachycardia or in preparation for I131 treatment or surgery. And propylthiouracil has more severe side effects than methimazole.
attempts to treat his hyperthyroidism may be affecting his quality of life worse than just coping with the hyperthyroidism and letting him eat like a normal kitty again. I say all this with no veterinary experience at all,
I say this with a great deal of veterinary experience: If the cat is allowed to remain hyperthyroid, it will progressively be more and more uncomfortable, it will hallucinate, it cannot sleep well, it can develop heart disease, its blood pressure can skyrocket with subsequent problems such as retinal hemorrhage, detachment of the retinas. Over time their absorptive ability in the gut will decrease markedly. They will lose more and more muscle mass. They will feel increasingly terrible.
OP, if that is ever where you're at, that your kitty's hyperthyroidism can't be controlled, please just please don't let your cat 'die naturally.' There are fates worse than death; see previous paragraph. Sometimes we have to hurt so they don't have to any more.
posted by Seppaku at 5:05 PM on March 29, 2018 [11 favorites]
I read that you recently had your cat's blood work tested but it is not unusual for older cats to have multiple issues (hyperthyroidism/renal insufficiency and GI disease). Sometimes hyperthyroidism can make renal disease harder to detect, for example.
Is transdermal methimazole an option? It has fewer GI side effects than oral formulations.
Has her dose of methimazole been adjusted in response to her total T4 levels and weight loss?
Another medication often given to cats for inappetence is mirtazapine. It is a generic human drug that is typically given to cats every 3 days. The cerenia and pepcid should also help with nausea.
>Maybe try some propanolol or some other beta-blocker, even if it's just palliative? Can he get propylthiouracil?
Or maybe not, since we use a more selective beta blocker for cats with hyperthyroidism only if we are seeing tachycardia or in preparation for I131 treatment or surgery. And propylthiouracil has more severe side effects than methimazole.
attempts to treat his hyperthyroidism may be affecting his quality of life worse than just coping with the hyperthyroidism and letting him eat like a normal kitty again. I say all this with no veterinary experience at all,
I say this with a great deal of veterinary experience: If the cat is allowed to remain hyperthyroid, it will progressively be more and more uncomfortable, it will hallucinate, it cannot sleep well, it can develop heart disease, its blood pressure can skyrocket with subsequent problems such as retinal hemorrhage, detachment of the retinas. Over time their absorptive ability in the gut will decrease markedly. They will lose more and more muscle mass. They will feel increasingly terrible.
OP, if that is ever where you're at, that your kitty's hyperthyroidism can't be controlled, please just please don't let your cat 'die naturally.' There are fates worse than death; see previous paragraph. Sometimes we have to hurt so they don't have to any more.
posted by Seppaku at 5:05 PM on March 29, 2018 [11 favorites]
Cerenia is great, also sometimes steroids will help increase appetite, but may cause kidney problems.
posted by evilmonk at 5:32 PM on March 29, 2018
posted by evilmonk at 5:32 PM on March 29, 2018
When my cat was really really sick and would not eat anything else, including fresh chicken breast and baby food -- he died in a day or two -- he would finally just eat crab meat, obtained from the seafood counter at the grocery store, and microwaved just enough to cook it. He and his brother went out of their minds for fresh crab. Maybe something to try. Seems to be easy enough to digest.
posted by amtho at 5:42 PM on March 29, 2018
posted by amtho at 5:42 PM on March 29, 2018
Response by poster: Thanks all for your feedback so far.
The biggest problem we're having is that no food item is palatable after, at most, a day. Food suggestions are appreciated, but believe me when I say we've tried every food we can get our hands on down here. What works one day will not work the next. We need to address the issue of him not eating, and that might be changing medication, or adding additional medication, or something we've missed entirely.
To answer some questions:
> Were the symptoms of his untreated hyperthyroidism worse than what he's going through now?
For three months prior to his diagnosis, he was eating 3 cans a day and losing weight, plus he was irritable as hell, so we knew something was off.
>15 is pretty old for a cat, and I wonder if these attempts to treat his hyperthyroidism may be affecting his quality of life worse than just coping with the hyperthyroidism and letting him eat like a normal kitty again.
Hyperthyroidism is a wasting disease and leaving him untreated would cause him great suffering.
> I read that you recently had your cat's blood work tested but it is not unusual for older cats to have multiple issues (hyperthyroidism/renal insufficiency and GI disease). Sometimes hyperthyroidism can make renal disease harder to detect, for example.
We've previously read up on this and discussed with our vet. He seems to think there is no kidney issue currently at hand. I've been reading about Chronic Kidney Disease, but the only symptoms in common are being super hungry, vomiting, and nausea.
> Is transdermal methimazole an option? It has fewer GI side effects than oral formulations.
We'll ask the vet about the transdermal. Someone mentioned to me today that Carbimazole might be an option which may be available in this country, and apparently has fewer side effects. We're going to ask about this as well.
> Has her dose of methimazole been adjusted in response to her total T4 levels and weight loss?
Yes. Initially his dosage was 10mg/day and that was too high for him. We backed way off and have been steadily increasing the dosage, but the nausea and vomiting has remained, regardless of dosage strength. He's currently at 5mg/day. At last bloodwork a month ago, he was still hyperthyroid, but only slightly. We do need to retest him and likely increase his dosage and it's quite possible Sam hasn't yet reached euthyroid, but our vet has stated that his negative reaction to the medication won't change once he has.
> I think you might have to do some custom cooking for him
We cannot. Our refrigeration system is inadequate for meat storage so this isn't a long-term solution for us. We can do these things only on the short-term. We've tried chicken and fish already, and it's palatable for him only for that moment and no other. It's super frustrating.
> Have you tried giving him cat treats?
Yes. Treats he used to go nuts for he'll barely register interest in now.
> Plain chicken or beef baby food
We've searched high and low in the towns we've been in and cannot find meat-based baby food in the markets. I spoke with a local and this is not something people feed their kids here.
>Another medication often given to cats for inappetence is mirtazapine.
Thank you! We'll bring this up to the vet!
>OP, if that is where you're at, that your kitty's hyperthyroidism can't be controlled, please just please don't let your cat 'die naturally.'
Thankfully, he's not there yet and we have no intention of taking him off medication or letting him suffer like this.
Thank you to everyone who has already responded, and please offer any additional suggestions that haven't yet been mentioned as we'll be going to the vet next week.
posted by vivzan at 5:52 PM on March 29, 2018
The biggest problem we're having is that no food item is palatable after, at most, a day. Food suggestions are appreciated, but believe me when I say we've tried every food we can get our hands on down here. What works one day will not work the next. We need to address the issue of him not eating, and that might be changing medication, or adding additional medication, or something we've missed entirely.
To answer some questions:
> Were the symptoms of his untreated hyperthyroidism worse than what he's going through now?
For three months prior to his diagnosis, he was eating 3 cans a day and losing weight, plus he was irritable as hell, so we knew something was off.
>15 is pretty old for a cat, and I wonder if these attempts to treat his hyperthyroidism may be affecting his quality of life worse than just coping with the hyperthyroidism and letting him eat like a normal kitty again.
Hyperthyroidism is a wasting disease and leaving him untreated would cause him great suffering.
> I read that you recently had your cat's blood work tested but it is not unusual for older cats to have multiple issues (hyperthyroidism/renal insufficiency and GI disease). Sometimes hyperthyroidism can make renal disease harder to detect, for example.
We've previously read up on this and discussed with our vet. He seems to think there is no kidney issue currently at hand. I've been reading about Chronic Kidney Disease, but the only symptoms in common are being super hungry, vomiting, and nausea.
> Is transdermal methimazole an option? It has fewer GI side effects than oral formulations.
We'll ask the vet about the transdermal. Someone mentioned to me today that Carbimazole might be an option which may be available in this country, and apparently has fewer side effects. We're going to ask about this as well.
> Has her dose of methimazole been adjusted in response to her total T4 levels and weight loss?
Yes. Initially his dosage was 10mg/day and that was too high for him. We backed way off and have been steadily increasing the dosage, but the nausea and vomiting has remained, regardless of dosage strength. He's currently at 5mg/day. At last bloodwork a month ago, he was still hyperthyroid, but only slightly. We do need to retest him and likely increase his dosage and it's quite possible Sam hasn't yet reached euthyroid, but our vet has stated that his negative reaction to the medication won't change once he has.
> I think you might have to do some custom cooking for him
We cannot. Our refrigeration system is inadequate for meat storage so this isn't a long-term solution for us. We can do these things only on the short-term. We've tried chicken and fish already, and it's palatable for him only for that moment and no other. It's super frustrating.
> Have you tried giving him cat treats?
Yes. Treats he used to go nuts for he'll barely register interest in now.
> Plain chicken or beef baby food
We've searched high and low in the towns we've been in and cannot find meat-based baby food in the markets. I spoke with a local and this is not something people feed their kids here.
>Another medication often given to cats for inappetence is mirtazapine.
Thank you! We'll bring this up to the vet!
>OP, if that is where you're at, that your kitty's hyperthyroidism can't be controlled, please just please don't let your cat 'die naturally.'
Thankfully, he's not there yet and we have no intention of taking him off medication or letting him suffer like this.
Thank you to everyone who has already responded, and please offer any additional suggestions that haven't yet been mentioned as we'll be going to the vet next week.
posted by vivzan at 5:52 PM on March 29, 2018
I will mention that a few months ago I took my kitty in for something unrelated and the vet thought that it might be a reaction related to the hyperthyroid med. He kind of implied that if we had to take her off that, there wasn’t much else he could do for her. And this is in the US. So you might find yourself bumping up against the limits of what can be done, which is a very frustrating place to be.
posted by bleep at 5:57 PM on March 29, 2018
posted by bleep at 5:57 PM on March 29, 2018
My late female cat had hyperthyroid and turned out to be allergic to the methimazole (oral had the results you're seeing here, topical produced a severe rash). The solution was the nuclear option--i.e., radioactive iodine treatment, to which she responded perfectly. There are practical issues to consider with this approach, as it requires some short-term protective measures afterwards (temporary isolation from small children, pregnant women, and older people; litter has to be stored for six months before it can be disposed of; etc.), and it's not cheap, but in my cat's case it definitely extended her life.
posted by thomas j wise at 6:11 PM on March 29, 2018 [1 favorite]
posted by thomas j wise at 6:11 PM on March 29, 2018 [1 favorite]
To be clear, I wasn't trying to say, "Oh, just stop the hyperthyroid drugs and he'll be better off!" I was wondering if that might be a possibility. Sounds like it isn't, unfortunately.
posted by Ursula Hitler at 6:27 PM on March 29, 2018
posted by Ursula Hitler at 6:27 PM on March 29, 2018
These are the exact symptoms my cat was experiencing. For my cat, it was determined to be either severe IBD, or lymphoma. The only way to determine which of the two it is is via a biopsy which she was too weak for, but to be honest, it doesn't matter as the treatment is the same. My vet came to her diagnosis via an ultrasound, but that may not even be strictly necessary either.
Take a look at IBDKitties.net and see if any of that sounds familiar to you. The owner of that site also runs a very helpful Facebook group.
in addition to the cerenia, a round of chlorambucil (basically a well-tolerated chemo) and what will probably be a lifetime of prednisolone (steriods) has done wonders for my cat. She went from 11 to 6 lbs at her lowest, but is now pretty stable at about 9.5 lbs. She's recently gone weeks without vomiting. Unfortunately she seems to be starting back up again (although not nearly as bad as before), so im back to a every-other-day dose of Cerenia. Regardless, I still dont know if it's IBD or cancer, but i am convinced the medications saved her - she was literally starving to death.
Also, have you tried chicken or beef baby food? Make sure it has no onions in it, but it's my "when all else fails" food that is always good for a meal or two. Also, even though my vet wasn't happy about it, i was so desperate to get calories in her I started giving her cream when i realized she'd eat it. At that point any calories were good calories.
Even today, where you wouldn't know from looking at her that she's sick, I can't get her to eat more than 1 to 1.5 solid meals of cat food a day, but chopped up roasted rotisserie chicken is what is keeping the weight on her currently.
Good luck, good wishes and head scritches to your poor kitty. It is so insanely frustrating and heartbreaking when they just wont eat and are just wasting away in front of your eyes.
posted by cgg at 7:03 PM on March 29, 2018
Take a look at IBDKitties.net and see if any of that sounds familiar to you. The owner of that site also runs a very helpful Facebook group.
in addition to the cerenia, a round of chlorambucil (basically a well-tolerated chemo) and what will probably be a lifetime of prednisolone (steriods) has done wonders for my cat. She went from 11 to 6 lbs at her lowest, but is now pretty stable at about 9.5 lbs. She's recently gone weeks without vomiting. Unfortunately she seems to be starting back up again (although not nearly as bad as before), so im back to a every-other-day dose of Cerenia. Regardless, I still dont know if it's IBD or cancer, but i am convinced the medications saved her - she was literally starving to death.
Also, have you tried chicken or beef baby food? Make sure it has no onions in it, but it's my "when all else fails" food that is always good for a meal or two. Also, even though my vet wasn't happy about it, i was so desperate to get calories in her I started giving her cream when i realized she'd eat it. At that point any calories were good calories.
Even today, where you wouldn't know from looking at her that she's sick, I can't get her to eat more than 1 to 1.5 solid meals of cat food a day, but chopped up roasted rotisserie chicken is what is keeping the weight on her currently.
Good luck, good wishes and head scritches to your poor kitty. It is so insanely frustrating and heartbreaking when they just wont eat and are just wasting away in front of your eyes.
posted by cgg at 7:03 PM on March 29, 2018
Cannabis? It might help make food more palatable for him, while reducing his nausea and pain. It sounds like you live somewhere where metered doses are likely unavailable, so you'd have to experiment. I'd recommend extracting it into butter or oil and adding it to his food (not a lot of it, he's tiny and has no tolerance) at a time when you're pretty sure he'll eat at least some of it. It won't harm him though he may find the effects distressing. If he does, you don't have to do it again.
I'm sorry to say though that this sounds like it may be almost the end for Sam, no matter what you do. By all means try anything you want to make him happier, but with the sad understanding that maybe nothing will work for long. My love to all of you in this painful time.
posted by Anticipation Of A New Lover's Arrival, The at 7:31 PM on March 29, 2018
I'm sorry to say though that this sounds like it may be almost the end for Sam, no matter what you do. By all means try anything you want to make him happier, but with the sad understanding that maybe nothing will work for long. My love to all of you in this painful time.
posted by Anticipation Of A New Lover's Arrival, The at 7:31 PM on March 29, 2018
Best answer: I see you've marked your question 'answered', but I don't think this has been suggested yet (in case you want/need additional options to consider):
We had a hyperthryoid cat who -- like yours -- got MUCH worse after taking the Methimazole. It was really frustrating and worrisome, because the vets didn't seem to accept/believe that it was the medication that was making things go downhill fast. In the end, we got him the radioactive iodine treatment, BUT I'd like to direct you to find a group of cat-owners going through the same thing. I can't seem to find the group immediately with a google search, but at the time I joined a very helpful group/board for hyperthyroid cats on Yahoo. Perhaps they don't exist any more (?), but a search led me to a similar-sounding Facebook group (if you are on FB):
https://www.facebook.com/Feline-Hyperthyroid-Information-176947552403642/
(see the top/pinned post for a link to the FB group)
If memory serves, one of the pieces of advice for helping to manage kitties who had a 'bad' reaction to Methimazole was to take the dose WAY DOWN and then VERY SLOWLY titrate back up over time to a medically acceptable/tolerated dose. It sounds like you have gone down a bit, but perhaps not enough?
I am not a veterinarian, of course, and I suggest you look for further information about the above-suggestion, but it sounds like it might be worth a try since your poor kitty seems to be having such a hard time with the medication. Best of luck to you and your fur-friend.
posted by Halo in reverse at 7:46 PM on March 29, 2018 [1 favorite]
We had a hyperthryoid cat who -- like yours -- got MUCH worse after taking the Methimazole. It was really frustrating and worrisome, because the vets didn't seem to accept/believe that it was the medication that was making things go downhill fast. In the end, we got him the radioactive iodine treatment, BUT I'd like to direct you to find a group of cat-owners going through the same thing. I can't seem to find the group immediately with a google search, but at the time I joined a very helpful group/board for hyperthyroid cats on Yahoo. Perhaps they don't exist any more (?), but a search led me to a similar-sounding Facebook group (if you are on FB):
https://www.facebook.com/Feline-Hyperthyroid-Information-176947552403642/
(see the top/pinned post for a link to the FB group)
If memory serves, one of the pieces of advice for helping to manage kitties who had a 'bad' reaction to Methimazole was to take the dose WAY DOWN and then VERY SLOWLY titrate back up over time to a medically acceptable/tolerated dose. It sounds like you have gone down a bit, but perhaps not enough?
I am not a veterinarian, of course, and I suggest you look for further information about the above-suggestion, but it sounds like it might be worth a try since your poor kitty seems to be having such a hard time with the medication. Best of luck to you and your fur-friend.
posted by Halo in reverse at 7:46 PM on March 29, 2018 [1 favorite]
Response by poster: Halo in reverse, I didn't mark this as resolved and can't see where I did, so let me know and I'll reach out to the mods to fix it. I did mark Seppaku's answer as a "best answer" so far, is that what you mean?
I'll join that group, thanks.
posted by vivzan at 7:59 PM on March 29, 2018
I'll join that group, thanks.
posted by vivzan at 7:59 PM on March 29, 2018
Ah, I found the Yahoo support group for HyperT cats:
https://groups.yahoo.com/neo/groups/feline-hyperT/info
And here is another forum where people talk about the standard dose of Meth given to cats as being too high (for many), with people suggesting you start at 1.25 2x/day and slowly go up as long as no negative reaction: http://www.catforum.com/forum/38-health-nutrition/181145-methimazole-dosage-hypert.html
I hope this helps your kitty!
posted by Halo in reverse at 8:02 PM on March 29, 2018 [1 favorite]
https://groups.yahoo.com/neo/groups/feline-hyperT/info
And here is another forum where people talk about the standard dose of Meth given to cats as being too high (for many), with people suggesting you start at 1.25 2x/day and slowly go up as long as no negative reaction: http://www.catforum.com/forum/38-health-nutrition/181145-methimazole-dosage-hypert.html
I hope this helps your kitty!
posted by Halo in reverse at 8:02 PM on March 29, 2018 [1 favorite]
Oh, I saw the little check-mark on your question which I thought meant it had been 'resolved', but maybe the check-mark only means you've selected a/some best answer(s). ?? Anyway...I still wanted to pass along the above info to you in case it could help you and your cat!
posted by Halo in reverse at 8:06 PM on March 29, 2018 [1 favorite]
posted by Halo in reverse at 8:06 PM on March 29, 2018 [1 favorite]
Best answer: (I'm a vet).
Yes to discussing carbimazole with your vet! There may be a feline licensed prolonged-release (Vidalta) or human generic available. Even though "in theory" carbimazole and methimazole "should" cause the same adverse reactions in an individual animal (as one is a metabolite of the other), I have found in practice that this is definitely not always the case. I have had cats have awful reactions to one drug and be fine on another. I even had one that did awfully on methimazole (Felimazole brand) AND Vidalta, but did and continues to do fine 5 years later on generic carbimazole (in fact, that cat was about to be euthanised and my old-school boss put it on the old-school human carbimazole and bam! Cat was fine). Thiamizole (Thyronorm) is yet another hyperthyroid medication available in my country (UK), not sure about where you are.
But yes, my first go to is trying different meds/formulations in cases of suspect adverse reactions. It doesn't always help, but it is worth considering.
Also, perhaps your vet has already done this, but as a vet, I find calling the veterinary drug company (e.g. Dechra if you're using Felimazole) really useful in cases like this. The drug company is obligated to help users of its products (vets) with adverse reactions and give advice. They have vets on staff whose job it is to help in difficult cases. And they absolutely do not just push you to continue using "their" drug if it's not the right thing. I know it may be a bit awkward but maybe ask your vet to get in contact with the drug company if they haven't already?
posted by peanut butter milkshake at 10:55 PM on March 29, 2018 [2 favorites]
Yes to discussing carbimazole with your vet! There may be a feline licensed prolonged-release (Vidalta) or human generic available. Even though "in theory" carbimazole and methimazole "should" cause the same adverse reactions in an individual animal (as one is a metabolite of the other), I have found in practice that this is definitely not always the case. I have had cats have awful reactions to one drug and be fine on another. I even had one that did awfully on methimazole (Felimazole brand) AND Vidalta, but did and continues to do fine 5 years later on generic carbimazole (in fact, that cat was about to be euthanised and my old-school boss put it on the old-school human carbimazole and bam! Cat was fine). Thiamizole (Thyronorm) is yet another hyperthyroid medication available in my country (UK), not sure about where you are.
But yes, my first go to is trying different meds/formulations in cases of suspect adverse reactions. It doesn't always help, but it is worth considering.
Also, perhaps your vet has already done this, but as a vet, I find calling the veterinary drug company (e.g. Dechra if you're using Felimazole) really useful in cases like this. The drug company is obligated to help users of its products (vets) with adverse reactions and give advice. They have vets on staff whose job it is to help in difficult cases. And they absolutely do not just push you to continue using "their" drug if it's not the right thing. I know it may be a bit awkward but maybe ask your vet to get in contact with the drug company if they haven't already?
posted by peanut butter milkshake at 10:55 PM on March 29, 2018 [2 favorites]
Here in the Netherlands, vets also offer surgery as an option for hyperthyroid cats. It worked well for one of ours. I know that it's not offered everywhere but I have no idea why this is.
Basically, the thyroid is removed. Some cats still need medication (but less) after that; some need none. I've been told that this is because when the thyroid develops, it travels through the cat's body and (sometimes ?) leaves 'islands' of active thyroid cells and these can be enough to fulfill the function of the removed organ.
posted by Too-Ticky at 4:08 AM on March 30, 2018
Basically, the thyroid is removed. Some cats still need medication (but less) after that; some need none. I've been told that this is because when the thyroid develops, it travels through the cat's body and (sometimes ?) leaves 'islands' of active thyroid cells and these can be enough to fulfill the function of the removed organ.
posted by Too-Ticky at 4:08 AM on March 30, 2018
Best answer: What you need to do today, right now, is get some food into kitty. Agreeing with above post re: the cycle of feeling bad > less eating > losing weight > feeling more bad > eating even less etc. Hopefully kitty will tolerate spoon or syringe feeding - start doing that immediately, with the best quality / highest calorie pate cat food you have access to. Multiple times a day, as much food as you can possibly get into him, gradually working up to the same amount of food he used to eat on his own. There's no guarantee that once he's properly nourished, that he'll feel better and start eating on his own. Maybe, maybe not. But I can guarantee that this is a critical malnourishment / low weight situation right now. Kidney and liver damage are imminent, if not already occurring. I lost a cat once because she was eating very little (stress issues) and that led to liver failure. Regardless of what you decide about thyroid treatment, it's essential to start putting weight back on, even by force.
posted by storminator7 at 12:23 PM on March 30, 2018 [3 favorites]
posted by storminator7 at 12:23 PM on March 30, 2018 [3 favorites]
Response by poster: An update: Sam had a really bad week and we thought he wouldn't make it, but he's still here. Last Friday, we started syringe-feeding, giving SQ fluids, and stopped the methimazole completely. His urea is high, but his thyroid levels are now in normal range and there are no liver or kidney issues. The vet has concluded that Sam needs different meds, so we're switching to Ipodate, which is available in this country.Sam is not out of the woods yet, he needs to put on weight, but there's a light at the end of the tunnel.
Thanks for everyone's help!
posted by vivzan at 6:28 PM on April 7, 2018 [3 favorites]
Thanks for everyone's help!
posted by vivzan at 6:28 PM on April 7, 2018 [3 favorites]
Response by poster: Final update: Sam passed away peacefully on April 14th. We're missing him every day. He was a very, very good kitty. Thank you all for your advice.
posted by vivzan at 12:16 PM on May 2, 2018 [2 favorites]
posted by vivzan at 12:16 PM on May 2, 2018 [2 favorites]
Sorry for your loss, vivzan. Sending love.
posted by Anticipation Of A New Lover's Arrival, The at 12:28 PM on May 2, 2018
posted by Anticipation Of A New Lover's Arrival, The at 12:28 PM on May 2, 2018
Just saw this. Sorry to hear it, vivzan. It sounds like he was a very loved cat and you worked hard to give him a happy life.
posted by Ursula Hitler at 6:40 PM on May 7, 2018
posted by Ursula Hitler at 6:40 PM on May 7, 2018
Oh, I'm so sorry, vivzan. He was lucky to have you, and lucky to be so loved right up to the end. Will be thinking good thoughts for you and him tonight.
posted by myotahapea at 1:06 PM on May 9, 2018
posted by myotahapea at 1:06 PM on May 9, 2018
This thread is closed to new comments.
posted by restless_nomad at 3:54 PM on March 29, 2018